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Monica Gandhi MD, MPH Profile picture
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26 Sep, 5 tweets, 2 min read
MISTAKEN MESSAGING: On this Sunday 9/26 we can get on top of 2 messages that went awry in US for 2 months (started 7/27): 1) vaccinated spread as readily as unvaccinated; 2) booster discussion means vaccines not working. Let's move past these; sorry they happened; neither true.
Here is an explanation of how (even with delta), vaccinated do not spread as readily as unvaccinated and likely very little if at all if you don't have symptoms by careful contact tracing studies
And here is an explanation by video of how CDC said this statement of "vax spread as readily as unvax" mistakenly on July 26 week but walked it back with new data coming out as evidenced by their online briefs which are great
news.yahoo.com/common-breakth…
And this is thread explaining how vaccines (even two-dose) are working really well so hopefully booster discussion won't deter you from thinking vaccines work
And here is a very short podcast where I explain that I think these two messages hurt us in US as every other country with high vaccinated rates kept very steady in their messaging that vaccines are the way out of the pandemic (which they are)
octavianreport.com/rostrum/what-i…

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
24 Sep
Okay, you can see public health people now trying to justify a 3rd shot & it is getting more and more complicated as we try to name different groups but the reason the initial booster announcement by Biden was so disarming WAS because of cellular immunity
This article explains how antibodies wane but cellular immunity brings them right back up!
leaps.org/how-long-do-co…
@mugecevik, @jakescottMD, and @AaronRichterman state that reports of waning effectiveness greatly exaggerated. At this point, too late. Biden said it; FDA tried to walk back; CDC added more criteria & took away some, we have to bumble through best we can
bmj.com/content/374/bm…
Read 8 tweets
Monica Gandhi MD, MPH Profile picture
23 Sep
When public health officials do not provide "off ramps", clear metrics of taking off and on restrictions, a city will be parodied. Europe did this cleanly (Denmark when 74% vax'd- no restrictions). CDC trying to do here: cdc.gov/mmwr/volumes/7…
sfgate.com/sf-culture/art…
France looked at COVID transmission rates in a region to decide when to remove masks for children. These are clean metrics, earns trust of the people, we are not doing this in US even as we admit the virus will be endemic
thelocal.fr/20210922/franc…
Decide on metrics to remove restrictions, relay cleanly, have public health officials say same thing or US will have deepening distrust. Denmark & so many places had high acceptance of vax because trusted public health. Ideas of school metrics here:
nytimes.com/2021/06/08/opi…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
22 Sep
ENDEMICITY. "Perspective | We won’t eradicate covid. The pandemic will still end"- my piece in @washingtonpost that explains what endemicity will look like with COVID. The virus has features that make it unlikely to be eradicated but we can achieve control
washingtonpost.com/outlook/2021/0…
Here, I explain the definitions of containment in the field of infectious diseases (control, eradication, elimination, extinction); definition of endemicity (doesn't cause undue burden of disease); emerging normalcy in countries with high vax rates (fervently hope for US too)
Didn't realize it was paywalled- here is the article to explain principles of ID
Read 13 tweets
Monica Gandhi MD, MPH Profile picture
21 Sep
JOHNSON & JOHNSON TWO DOSE DATA TODAY: First, want to remind us how J&J vaccine works. More "traditional vaccines" are proteins of the vaccine combined with an adjuvant (see thread on Novavax). J&J and mRNA vaccines novel in that they put genetic material of the spike protein
into a lipid container (mRNA vaccines) or into a benign cold virus (DNA inside an adenovirus vector with J&J) and then YOU as the host take that genetic material and code it into the spike protein to which you raise immune response (mRNA or DNA & spike protein degrade right away)
So, what did J&J press release show today? That even ONE dose conferred long-lasting protection against hospitalizations/death (81% protection against hospitalizations median 4 months in study) and that is because of yes, cellular immunity. Effectiveness
jnj.com/johnson-johnso…
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
20 Sep
BREAKING NEWS: Pfizer releases results of 5-11 year old trial for its vaccine. 2-dose 10 microgram regimen (Pfizer uses 30 mcg for 12 and up) administered 21 days apart (sigh, we now know we need longer duration between doses for better effectiveness)
pfizer.com/news/press-rel…
4500 person trial of 6 months-11 years (FDA asked Pfizer to enroll more) & this data is for 2,268 participants aged 5 to 11. This phase 2/3 study looked at safety & immune reactions only (antibodies not T cells) - no endpoints of symptomatic disease. Found safety same as 12 & up
and antibody titers high (didn't give breakdown of those with and without prior SARS-CoV-2 infection; both groups enrolled in this phase 2/3 study). This will lead to filling of EUA for 5-11 & suggest further detail on safety, any effectiveness data?, continuing follow-up
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
20 Sep
Interesting paper from July: "Clinical evidence that the pandemic from 1889 to 1891 commonly called the Russian flu might have been an earlier coronavirus pandemic". Genetic detective work in the study suggests that a common cold coronavirus, HCoV-OC43,
sfamjournals.onlinelibrary.wiley.com/doi/full/10.11…
which NOW only causes mild upper respiratory tract infections, may in fact have caused a major pandemic (1889-1891) about 30 years before the 1918 (H1N1) influenza pandemic. A few tentative lessons: 1) it ended on its own, without a vaccine; 2) it did not go away completely
(i.e., we have probably all had it); 3) as it became entrenched ("endemic"), became milder; it became a cold - this was a possible future for COVID-19 and now with vaccines, the virus can be defanged. Vaccines limit further mutations of COVID-19 seen here
medrxiv.org/content/10.110…
Read 5 tweets

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